_ Aue 15 2002 THE TREASURER OF THE STATE OF FLORIDA Deeetted RFE ern DEPARTMENT OF INSURANCE . a _ TOM GALLAGHER DA-Y36l PL IN THE MATTER OF: CASE NO.: 60378-02-AG THOMAS EDWARD POLLOCK . ADMINISTRATIVE COMPLAINT TO: THOMAS EDWARD POLLOCK 31127 US Highway 19 North Palm Harbor, FL 34684-4438 THOMAS EDWARD POLLOCK 1200 Ridgegrove Drive South Palm Harbor, FL. 34683-2044 - You, THOMAS EDWARD POLLOCK, are hereby notified that the Insurance Commissioner of the State of Florida has caused to be made an investigation of your activities while licensed as an insurance agent in this state, as a result of which it is alleged: GENERAL ALLEGATIONS 1, Pursuant to Chapter 626, Florida Statutes, at all times pertinent to the dates and occurrences referred to herein, you, THOMAS EDWARD POLLOCK, were licensed in this state ag a Life, Health, and Variable Annuity Contract Agent, and are currently: so licensed, license LD. #4209175. 2 At all times pertinent to the dates and occurrences referred to herein, you, THOMAS EDWARD POLLOCK, were licensed in this state as an insurance agent. EB 35d S30IAISS WOT 2067267058 LOBES p0S8F> RA EF ejourey 06728058 “wepues Zb :soBed Wd 0:2 soul, 20/6/6 9720 (papesoong judg) }UaAq peajaoey o™ os 3. Pursuant to Chapter 626, Florida Statutes, the Florida Department of Insurance has jurisdiction over your insurance licenses and appointments. 4. For the years 1993 through 2001, you, THOMAS EDWARD POLLOCK, falsely and fraudulently obtained and misappropriated annual insurance premium monies from the St. Petersburg Junior College for insurance Coverage never afforded by any insurance company authorized to conduct business in the state of F lorida. COUNT I 5. The above general allegations are hereby realleged and fully incorporated herein by reference. 6, In 1993, you, THOMAS EDWARD POLLOCK, as a licensed insurance agent, conferred with representatives of St. Petersburg Junior College for the purpose of selling a cancer medical reimbursement plan of insurance to be Provided by Security Life Insurance Company of America. You falsely portrayed yourself as an authorized Teprescntative of that company, presented false documentation in behalf of that company to include listing yourself as “plan administrator”. In fact you were'not then or thereafter an authorized representative of Security Life Insurance Company and no insurance coverage was ever then or thereafter provided by that company or any other authorized insurance company for the benefit of St. Petersburg Junior College. Your false and fraudulent representations were Nonetheless accepted by representatives of St. Petersburg Junior College and it then purchased what it believed to be valid insurance coverage afforded by Security Life Insurance Company by furnishing to you an annual premium check in the Sum of $35,226.00 payable to Cancer Medical Reimbursement Plan c/o Tom Pollock, 2753 State Road 580, Clearwater, Florida for coverage during the 1993-94 year, 2 Pa vg SSOIANRS WERT 206p2abag9 LOB 23 p08822 AA e9 ejowoy L06rZ80S9 epues eL sseBeg Wd 0¢:2 soul, Z0/6/6 79ajeq (pepeesang jung) JUDAZ paatasay 7. In subsequent years through 2001, St. Petersburg Jr. College annually purchased what it believed to be valid insurance coverage for a Cancer Medical Reimbursement Plan by issuing and providing to you, THOMAS E. POLLOCK, the following annual premium checks: 1993-1994 ~ $35,226; 1994-1995 - $35,834; 1995-1996 ~ $35,606; 1996-1997 - $37,996; 1997- 1998 - $47, 892; 1998-99 - $46,750; 1999-2000 $48,900; 2000-2001 - $50,550. Each and every of those checks were deposited to account number 1263563970 originally maintained by Bamett Bank which subsequently became Nationsbank and which subsequently became Bank of America. You were at all times sole signatory to this bank account. All such premium monies furnished to you by St. Petersburg Jr. College for purported insurance coverage were misappropriated, converted and unlawfully utilized by you for your own use and benefit and were not at any time remitted to any insurance company authorized to conduct business in the state of Florida for the purpose of affording St. Petersburg Jr. College valid insurance coverage. 8, You, THOMAS EDWARD POLLOCK, in order to perpetuate your fraudulent scheme during the period of time described, caused all claims arising under your illegal "plan of insurance” to be filed with you as “plan administrator". You then made payment of same from proceeds which you personally controlied, while at all times utilizing premium funds collected from St. Petersburg Jr. College in excess of all claims paid for your own use and benefit. 9, In 2001 St. Petersburg Jr. College representatives discovered that you, THOMAS EDWARD POLLOCK, had for the years 1993 through 2001 falsely and fraudulently sold to it a nonexistent cancer medical reimbursement insurance plan not underwritten by any authorized insurance company, and all as a means to falsely obtain insurance premium monies from St. Petersburg Jr. College which monies were then and thereafter misappropriated, converted, and unlawfully utilized by you for your own use and benefit. 3 Sa 2Ovd SS0IAN3S W937 LO6PCEVBS8 GEES pyS 822 /AALCF eyowoy 206728%0S8 wapuesg rd rseBed Wd 0¢:2 rou), Z0/6/6 :e7eq (papeasons yueag) UGA paajaooy TT IS THEREFORE CHARGED that you, THOMAS EDWARD POLLOCK, have violated or are accountable under the following provisions of the Florida Insurance Code and Rules of the Department of Insurance which constitute grounds for the suspension or revocation of your licenses and appointments: (a) No person may be, act as, or advertise himself or herself out to be an insurance agent, Customer representative, solicitor, or adjuster unless he or she is currently licensed and appointed. [Section 626.1 12(1), Florida Statutes]; (b) No agent, customer representative, or solicitor shall solicit or otherwise transact as agent, customer representative, or solicitor, or represent or hold himself or herself out to be an agent, customer Tepresentative, or solicitor as to, any kind or kinds of insurance as to which he or she is not then licensed and appointed, [Section 626.1 12(2), Florida Statutes]; (c) No agent licensee shalt transact or attempt to transact under his or her license any line of insurance for which he or she does not have currently in force of tecord with the Department an appointment by and authorized insurer, [Section 626.211(4), Florida Statutes); (4) = Any agent, customer répresentative, solicitor, or adjuster who, not being lawfully entitled thereto, either temporarily or permanently diverts or misappropriates such funds or any portion thereof or deprives the other person of a benefit therefrom commits the offense specified " below: (d) If the funds diverted or misappropriated are $100,000 or more, a felony of the first degree. [Section 626.561(3), Florida Statutes); (e) Fraudulent or dishonest Practices in the conduct of business under the license or ' appointment. [Section 626.61 1(9), Florida Statutes); 4 50 Nd S201NE5 “WOT LOGrcaracs GB sy bycRREZ/RRKEY eromioy LO6bZ8P0S8 wepues Zz ‘seBeg Wd 0:2 TOU L Z0/6/6 :638q (pepsacons yueag) JUGAQ peAtoday (63) Misappropriation, conversion, or unlawful withholding of monies belonging to insurers or insureds or beneficiaries or to others and received in conduct of business under the license or appointment. [Section 626.611(10), Florida Statutes]; (g) Willful failure to comply with, or willful violation of, any proper order or rule of the department or willful violation of any provision of this code. [Section 626.61 1(13), Florida Statutes); (h) In the conduct of business under the license or appointment, engaging in unfair methods of competition or in unfair or deceptive acts or practices, as prohibited under part IX of this chapter, or having otherwise shown himself or herself to be a source of injury or loss to the public or detrimental to the public interest. [Section 626.621(6), Florida Statutes); (i) Knowingly making, issuing, circulating or causing to be made, issued or circulated, any estimate, iffustration, circular, statement, self representation, omission, or comparison which is untrue, deceptive, or misleading. [Section 626.9541(1)(b), Florida Statutes), WHEREFORE, you, THOMAS EDWARD POLLOCK, are hereby notified that the Treasurer and Insurance Commissioner intends to enter an Order suspending or revoking your licenses and appointments as an insurance agent or to impose such penalties as may be provided under the provisions of Sections 626.611, 626,621, 626.681, 626.691, and 626.9521, Florida Statutes, and under the other referenced sections of the Florida Statutes as set out in this Administrative Complaint. 3 46 300d S30IAYSS W937 206b298beS8 LOS 87808822 RAEI ejowey LO67L840S8 s4puas ray reabed Wd 0F:% *OUL cO/6/6 638 (pepeasons yuedg) yueAg paaiaoey CE OF HITS You have the right to request a proceeding to contest this action by the Department pufsuant to sections 120.569 and 120.57, Florida Statutes, and Rule 28-107, Florida Administrative Code. The proceeding request must be in writing, signed by you, and must be filed with the Department within twenty-one (21) days of your receipt of this notice. Completion of the attached Election of Proceeding form and/or a petition for administrative hearing wil] suffice as a written request. The Tequest must be filed with the General Counsel as acting Agency Clerk, at the Florida Department of Insurance, 612 Larson Building, 200 East Gaines Street, Tallahassee, Florida 323 99-0333. Your written tesponse must be received by the Department no later than 5:00 P.m. on the twenty-first day after your receipt of this notice. Mailing the response on the twenty-first day wilt not preserve your right to a hearing. YOUR FAILURE To RESPOND IN WRITING WITHIN TO REQUEST A PROCEEDING ON THE MATTERS ALLEGED HEREIN AND AN ORDER OF REVOCATION WILL BE ENTERED AGAINST YOU. If you request a proceeding, you must provide information that complies with the Tequirements of Rule 28-107.004, Florida Administrative Code. As noted above, completion of the attached Election of Proceeding form conforms to these requirements. Specifically, your response must contain: (a) The name and address of the party making the request, for purpose of service; (bo) — A statement that the party is requesting a hearing involving disputed issues of material fact, or a hearing not involving disputed issues of material fact; and (c) A reference to the Notice, order to show cause, administrative complaint, or other communication that the party has received from the agency. 6 88 350d S30TANRS WOST 206>28>9Se LORS RB roRRE2 “REG ejowey 2066187058 “4epueg Zt ‘seBeg Wd 0¢:Z seul. Z0/6/6 707eq (Pepaesong juaag) JUGAQ peatovey Ifa hearing of any type is requested, you have the right to be represented by counsel or other qualified representative at your expense, to present evidence and argument, to call and cross-examine witnesses, and to compel the attendance of witnesses and the production of documents by subpoena. Ifa proceeding is requested and there is no dispute of material fact, the provisions of section 120.57(2), Florida Statutes, apply. In this regard, you may submit oral or written evidence in opposition to the action taken by the Department or a written statement challenging the grounds upon which the Department has relied. While a hearing is normally not required in the absence of a dispute of fact, if you feel that a hearing is necessary, one will be conducted in Tallahassee, Florida, or by telephonic conference call upon your request. However, if you dispute material facts which are the basis for the Department’s action, you must request an adversarial proceeding pursuant to sections 120.569 and 120,57(1), Florida Statutes, These proceedings are held before a State administrative law judge of the Division of Administrative Hearings. Unless the majority of witnesses are located elsewhere, the Department will request that the hearing be conducted in Tallahassee, Florida. Failure to follow the procedure outlined with regard to your response to this notice may result in the request being denied, All prior oral communication or correspondence in this matter shall be considered freeform agency action, and no such oral communication or correspondence shall operate as a valid request for an administrative proceeding. Any request for an administrative proceeding received prior to the date of this notice shall be deemed abandoned unless timely renewed in compliance with the guidelines as set out above. Mediation of this matter pursuant to section 120.573, Florida Statutes, is not available. No Department attorney wil] discuss this matter with you until the response has been received by the Department of Insurance, 7 68 aovd SaOIMGS WS) LOGPLBPOSS GBS FEyoR PRAY erowon 406¢2870S8 ss0pueg Z isebed Wd 0¢:z OWL ZO/6/6 0980 (papaeoans yueAg) JueA paaleodsy DATED and SIGNED this__15¢h gay op August , 2002, KENNEY SHIPLEY Deputy Insurance Commissioner 8 @T 390d S20IANaS WesT 2£86>28pasa LOS¥ 28 y098°? “ER ESPosouoy L06r28b0S¢ apueg Zt iseBeg Wd 0¢:z ToUulyy Z0/6/6 :978q (pepeasons yuany) USA parjooay CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the foregoing ADMINISTRATIVE COMPLAINT and ELECTION OF RIGHTS have been furnished to: THOMAS EDWARD POLLOCK, 31127 US HIGHWAY 19 NORTH, PALM HARBOR, FL 34684-4438; and THOMAS EDWARD POLLOCK, 1200 Ridgegrove Drive South, Palm Harbor, FL 34683-2044, by Certified Mail this 15th day of _ August . 2002. Dean Andrews Division of Legal Services 200 East Gaines St. 612 Larson Building Tallahassee, Florida 32399-033 (850) 413-4242 . Florida Bar Number 0001959 Tl 30vd S3OIAU3S WOT1 CBEPLBPBSR JB EYa ree RAED orowey 206¢28%0S8 usepusg ra sseGeg Wd 0v:z rowLL zo/e/6 2038q —————_—————— eee HET (papsazong yuan) juerg paareoey

Docket for Case No: 02-004361PL